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The ESR (Erythrocyte Sedimentation Rate) test measures how fast red blood cells (erythrocytes) settle in a tube over one hour.

When your body is inflamed, certain proteins, mainly fibrinogen, increase in the blood. These proteins cause the red blood cells to stick together in stacks. These stacks settle faster, leading to a higher ESR.

The ESR test shows that inflammation is present. However, it cannot tell you exactly where the inflammation is or what is causing it. That’s why doctors usually do this test along with other tests. This helps them understand and treat your health problems.

What Do the Results Mean?

Pathological Factors 

The CBC (Complete Blood Count) test measures the number of red blood cells (RBCs), white blood cells (WBCs), and platelets. Each of these blood cells performs essential functions–RBCs carry oxygen from your lungs to the various body parts, WBCs help fight infections and other diseases, and platelets help your blood to clot. Therefore, determining their levels can provide significant health information. A CBC test also determines the hemoglobin level, a protein in RBC that carries oxygen from the lungs to the rest of your body. Evaluating all these components together can provide important information about your overall health.

The Cholesterol - LDL test measures the concentration of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol plays an important role in your body. It carries cholesterol from your liver to other parts of the body where it's needed for things like building cell walls and making hormones. However, it is often referred to as "bad" cholesterol because when present in excess in your blood, it can stick to your blood vessel walls leading to the formation of plaque, making them narrow and less flexible. When this happens, it's harder for the blood to flow, which can lead to heart problems, like heart attacks and strokes. By measuring LDL cholesterol levels, your doctor can assess your risk of developing cardiovascular diseases and can recommend appropriate preventive or treatment strategies.

The Triglycerides test measures the amount of triglycerides in the blood and helps evaluate your risk of developing cardiovascular diseases. Triglycerides are a type of fat (lipid) that your body uses as a source of energy. When you consume more calories than your body needs, the excess calories are converted into triglycerides and stored in fat cells for later use. High triglyceride levels can contribute to the hardening and narrowing of arteries, increasing the risk of heart attack, stroke, and other related conditions. 

The Cholesterol - Total test measures the total amount of cholesterol (fats) in your blood. Cholesterol is mainly synthesized in the liver and partially in the intestines. It acts as a building block for cell membranes, is a precursor to vital hormones, and helps produce bile acids that help digest fats. Cholesterol is transported through the blood as lipoproteins: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). An optimal amount of these proteins is necessary for proper body functioning.

The Cholesterol - HDL test measures the concentration of high-density lipoprotein (HDL) cholesterol in the blood. HDL cholesterol plays a crucial role in maintaining cardiovascular health, as it helps transport excess low-density lipoprotein (LDL) cholesterol from the bloodstream back to the liver for excretion. This process prevents plaque buildup on the blood vessel walls, which can cause them to become narrow and less flexible. Higher HDL cholesterol levels are generally associated with a lower risk of heart problems, such as heart attacks and strokes. By measuring HDL cholesterol levels, your doctor can assess your risk of developing cardiovascular diseases and recommend appropriate preventive or treatment strategies, including lifestyle modifications and medications.

The Very Low Density Lipoprotein test measures the concentration of very-low-density lipoprotein (VLDL) cholesterol in the blood. VLDL cholesterol plays a vital role in the body's metabolic processes. It is produced by the liver and is used to transport triglycerides, a type of fat, from the liver to various tissues throughout the body, where they are either utilized for energy or stored for later use. Though VLDL cholesterol is essential for the body's normal functioning, it is harmful if present in excess amounts. By measuring VLDL cholesterol levels, your doctor can assess your risk of developing cardiovascular diseases and recommend appropriate preventive or treatment strategies.

The Total Cholesterol/HDL Cholesterol Ratio test measures the ratio of total cholesterol and high-density lipoprotein (HDL)/good cholesterol in your blood which is a significant indicator of cardiovascular health. This ratio is calculated by dividing the total cholesterol by the HDL number. A high ratio indicates a higher amount of 'bad' cholesterol relative to 'good' cholesterol, implying a higher risk of developing heart disease. Conversely, a lower ratio implies a higher amount of 'good' cholesterol relative to 'bad' cholesterol, indicating a lower risk.

An LDL/HDL Ratio test measures the ratio of low-density lipoproteins (LDL) to high-density lipoproteins (HDL) in your blood. These two types of lipoproteins carry cholesterol throughout the body. LDL, often referred to as the 'bad' cholesterol, carries cholesterol to the cells that need it. However, if there is too much LDL cholesterol in the blood, it can combine with other substances and form plaque in the arteries, leading to cardiovascular diseases. On the other hand, HDL, often referred to as the 'good' cholesterol, helps remove other forms of cholesterol, including LDL, from the bloodstream. It transports cholesterol back to the liver, where it is broken down and eliminated from the body, thus reducing the risk of cholesterol buildup and heart disease. The LDL/HDL ratio is a significant indicator of cardiovascular health. A high ratio indicates a higher amount of 'bad' cholesterol relative to 'good' cholesterol, implying a higher risk of developing heart disease. Conversely, a lower ratio implies a higher amount of 'good' cholesterol relative to 'bad' cholesterol, indicating a lower risk.

The Non HDL Cholesterol test looks for the “bad” cholesterol particles that are likely to contribute to heart problems. These bad particles include LDL (low-density lipoprotein) cholesterol, VLDL (very-low-density lipoprotein) cholesterol, and remnants of other cholesterol-carrying molecules. Cholesterol is a waxy substance that circulates in your bloodstream and is essential for various bodily functions. However, too much of “bad” types of cholesterol can build up in your arteries and increase the risk of heart conditions. LDL and VLDL cholesterol particles are often referred to as the "bad" cholesterol because they can stick to the walls of your arteries and form plaque, narrowing the arteries and restricting blood flow to your heart. By measuring non-HDL cholesterol, your doctor can assess your risk of heart disease and determine if any interventions or lifestyle changes are needed to protect your heart.

Gamma-Glutamyl Transferase (GGT) is an enzyme found in various organs, with the highest concentration in the liver. Usually, this enzyme is present in low levels in the blood. However, when there is liver damage or disease, GGT is released into the bloodstream, causing an increase in GGT levels. In addition to the liver, GGT can also be elevated in conditions affecting the bile ducts or the pancreas. It is usually, the first liver enzyme to rise in the blood when there is any damage or obstruction in the bile duct, making it one of the most sensitive liver enzyme tests for detecting bile duct problems.

An SGPT (Alanine Transaminase) test measures the amount of alanine transaminase (ALT) or SGPT enzyme in your blood. ALT is most abundantly found in the liver but is also present in smaller amounts in other organs like the kidneys, heart, and muscles. Its primary function is to convert food into energy. It also speeds up chemical reactions in the body. These chemical reactions include the production of bile and substances that help your blood clot, break down food and toxins, and fight off an infection.

Elevated levels of ALT in the blood may indicate liver damage or injury. When the liver cells are damaged, they release ALT into the bloodstream, causing an increase in ALT levels. Therefore, the SGPT/ALT test is primarily used to assess the liver's health and to detect liver-related problems such as hepatitis, fatty liver disease, cirrhosis, or other liver disorders.

An Alkaline Phosphatase (ALP) test measures the quantity of ALP enzyme present throughout the body. The main sources of this enzyme are the liver and bones. It exists in different forms depending on where it originates, such as liver ALP, bone ALP, and intestinal ALP. In the liver, it is found on the edges of the cells that join together to form bile ducts. 

ALP levels can be increased during pregnancy as it is found in the placenta of pregnant women. It is also higher in children because their bones are in the growth phase. ALP is often high during growth spurts (a short period when an individual experiences quick physical growth in height and body weight).

An SGOT (Aspartate Aminotransferase) test measures the levels of serum glutamic-oxaloacetic transaminase (SGOT), also known as aspartate aminotransferase (AST), an enzyme produced by the liver. SGOT is present in most body cells, most abundantly in the liver and heart. The primary function of this enzyme is to convert food into glycogen (a form of glucose), which is stored in the cells, primarily the liver. The body uses this glycogen to generate energy for various body functions.

The Protein Total, Serum test measures the amount of proteins in the body. Proteins are known as the building blocks of all cells and tissues. They play a crucial role in the growth and development of most of your organs and in making enzymes and hormones. There are two types of proteins found in the body, namely albumin and globulin. About 60% of the total protein is made up of albumin, which is produced by the liver. It helps to carry small molecules such as hormones, minerals, and medicines throughout the body. It also serves as a source of amino acids for tissue metabolism. On the other hand, globulin is a group of proteins that are made by the liver and the immune system. They play an important role in liver functioning, blood clotting, and fighting off infections.

The Bilirubin (Total, Direct and Indirect) test measures the level of three forms of bilirubin such as total bilirubin, direct (conjugated bilirubin), and indirect (unconjugated) bilirubin in the blood. Total bilirubin represents the sum of direct and indirect bilirubin. Direct bilirubin is the water-soluble form of bilirubin that has been processed by the liver via a conjugation process with glucuronic acid and is ready to be excreted into the bile ducts and ultimately into the intestines. Indirect bilirubin is the water-insoluble form of bilirubin that has not yet been processed by the liver and is bound to albumin in the blood. It is formed in the spleen and liver during the breakdown of hemoglobin from old or damaged red blood cells and cannot be excreted directly by the liver. Instead, it is transported to the liver, where it undergoes conjugation to become direct bilirubin. 

Getting tested with the Bilirubin (Total, Direct and Indirect) test provides valuable information into various aspects of liver function, bile duct health, and the body’s ability to break down and eliminate bilirubin.

The Serum Creatinine test measures the creatinine level, a byproduct produced by the wear and tear of muscles during energy production. Since kidneys help filter creatinine, this test helps determine how well your kidneys work. Usually, high levels of creatinine in the blood signal diminished kidney function. At the same time, low levels may indicate decreased muscle mass.

What Do the Results Mean?

Pathological Factors 

Physiological Factors

🧒 Age: Creatinine levels may decrease with age (due to reduction in muscle mass).

🫄 Pregnancy: Slightly lower levels can be seen due to physiological changes in kidney function during pregnancy.

Lifestyle Factors

🥗 Diet: High protein intake may transiently increase creatinine.

🏋️ Exercise: Intense physical activity can temporarily elevate creatinine levels.

💊 Medications: Some medicines, such as NSAIDs, antibiotics, or certain blood pressure medications, may influence kidney function and creatinine levels.

Disclaimer: This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalized guidance.

What Do Normal Serum Creatinine Levels Mean?

Normal serum creatinine levels indicate that the kidneys are functioning properly and effectively filtering waste products from the blood.

What Do High Levels of Serum Creatinine Indicate?

High serum creatinine may indicate impaired kidney function, dehydration, urinary tract obstruction, or other conditions affecting renal health.

What to Do if Your Serum Creatinine Is Higher Than Normal?

If your creatinine level is higher than normal, consult your doctor for proper guidance. They may recommend additional tests, lifestyle adjustments, medication review, or referral to a nephrologist.

What Do Low Levels of Serum Creatinine Indicate?

Low levels are uncommon but may indicate low muscle mass, malnutrition, or liver disease. Always discuss results with your healthcare provider.

Can Serum Creatinine Results Be Inaccurate?

Yes, serum creatinine results can sometimes be inaccurate. Factors such as severe muscle loss, certain medications or supplements, and variations or errors in laboratory test methodologies can affect the accuracy of the results.

What Factors Can Affect Serum Creatinine Results?

Though a reliable test, several factors can influence accuracy:

• Muscle mass, age, sex
• Diet, hydration status
• Medications affecting kidney function
• Severe illness or trauma
• Hyperbilirubinemia

What Follow-Up Tests May Be Required?

Depending on your serum creatinine results, your doctor may recommend additional tests to get a clearer picture of kidney health. These can include urine tests, such as urine protein or microalbumin or cystatin C, to detect early kidney damage; an eGFR calculation to estimate kidney filtration efficiency; kidney imaging, like an ultrasound, to check for structural abnormalities; and electrolyte or kidney function panels to assess overall kidney performance and detect any imbalances. Fasting is not recommended for this test, you can eat and drink as per your daily routine.

Table: Tests Commonly Ordered Alongside the Serum Creatinine Test

How Does the Serum Creatinine Test Differ from Other Kidney Tests?

The Serum Creatinine test directly measures kidney filtration and indicates how efficiently the kidneys remove creatinine from the blood. Other kidney-related tests include:

BUN/Urea: Gives an idea of how well your kidneys are working. The levels can change with your diet or water intake.

Uric Acid: Checks the amount of uric acid in your blood. High levels may mean kidney or metabolism problems.

Serum Electrolytes: Measures important minerals like sodium, potassium, and chloride to check your body’s mineral balance.

BUN/Creatinine Ratio: Helps doctors find out if you have kidney issues or dehydration.

eGFR: Estimates your overall kidney function based on creatinine level, age, sex, and body size.

Creatinine Clearance: Compares blood and urine creatinine to see how well your kidneys filter waste.

Urine Creatinine: Measures the amount of creatinine in urine to help evaluate kidney health.

While these tests complement each other, Serum Creatinine specifically reflects kidney filtration efficiency, making it a key indicator of renal health.

The Uric Acid, Serum test measures the amount of uric acid in your blood. Uric acid is a waste product formed when the body breaks down purines. Purines are the natural substances found in your body’s cells (DNA) and in certain foods like red meat or seafood. Under normal conditions, uric acid dissolves in the blood, passes through the kidneys, and is excreted in the urine. When this process doesn’t work properly, due to either increased production or reduced elimination, the uric acid can build up in the blood. This may indicate underlying health issues such as kidney dysfunction, gout, or the presence of kidney stones. In some cases, the exact reason for high uric acid levels is unclear. On the other hand, low uric acid levels are rarely a cause for concern. This test helps doctors understand if uric acid levels are within a healthy range and whether further evaluation or treatment is needed.

What Do the Results Mean?

Pathological Factors

Physiological Factors

🧒 Age: Uric acid level rises every 10 years in men. However, it only begins increasing after the age of 50 in women. 

🧑‍🦳 Gender: Men generally have higher uric acid levels than women.

🫄 Pregnancy: Uric acid levels tend to drop during early pregnancy due to hormonal changes. These levels return to normal as the pregnancy progresses.

🩸Menopause: Uric acid levels are higher after menopause due to low estrogen levels. 

Lifestyle Factors

🏃 Exercise: Weight loss and physical exercise lower uric acid levels. 

🥗 Diet: Eating purine-rich foods (such as alcohol, red meat, seafood, etc., and fructose- or sugar-containing beverages) increases the uric acid levels.

😟Stress: Stress can affect blood cortisol levels and thus uric acid concentrations.

💊Medications: Medicines, such as diuretics, immunosuppressants, chemotherapeutic agents, etc., can affect uric acid removal. Therefore, they increase uric acid levels.

Geographical Location: High-altitude regions, such as mountains, can also increase the uric acid production, raising its levels. 

Disclaimer: This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalized guidance.

What Do Normal Uric Acid, Serum Levels Mean?

Normal uric acid levels suggest proper breakdown of purines and uric acid removal. It means your kidneys are working properly. It means that you have a low risk of other health problems like kidney stones, gout, or kidney problems.

What Do High Levels of Uric Acid, Serum Indicate?

High uric acid levels (hyperuricemia) indicate problems in uric acid synthesis or removal. This can happen due to kidney issues and can lead to gout and kidney stones. Also, these levels increase the chances of diabetes, high blood pressure, and heart disease.

What to Do if the Levels Are Higher Than Normal?

If your uric acid levels are higher than normal, it may indicate conditions such as gout, kidney disease, or metabolic disorders. Your doctor will evaluate your symptoms and may suggest lifestyle changes like reducing intake of purine-rich foods, limiting alcohol and sugary drinks, and staying well-hydrated to help flush out excess uric acid.

What Do Low Levels of Uric Acid, Serum Indicate?

Low uric acid levels (hypouricemia) result from increased uric acid removal from the body or decreased production of uric acid. It can occur due to certain medicines or health issues, such as problems in the kidneys, thyroid, or parathyroid glands. Generally, low uric acid levels do not show any symptoms. However, they are associated with muscle weakness, fatigue, and rare genetic disorders. Low uric acid levels are not very common and are often discovered incidentally during routine blood tests. Since low readings can have different causes, always consult a doctor to understand what they mean in your specific case.

Can Uric Acid, Serum Results Be Inaccurate?

Yes. Certain conditions can affect test accuracy. If your uric acid serum test results do not align with your symptoms or overall health, your doctor may recommend repeating the test or ordering additional investigations.

What Factors Can Affect Uric Acid, Serum Results?

Though it is a reliable test, several factors can influence the accuracy:

• Diet including purine-rich or fructose-containing foods
• Alcohol
• Certain medications, like diuretics or immunosuppressants 
• Pregnancy 
• Menopause
• Age
• Dehydration 
• Exercise
• Certain medical conditions, like kidney diseases or cancer

What Follow-Up Tests May Be Required?

Based on your uric acid results, your doctor may recommend additional tests to get a clearer picture of your health or to monitor possible complications. These may include kidney panels, cholesterol testing, or a CBC test.

Table: Tests Commonly Ordered Alongside Uric Acid, Serum: 

The Blood Urea Nitrogen test measures the levels of urea nitrogen in the blood. Blood urea is a waste product that is formed in the liver when you eat food and the protein is metabolized into amino acids. This process leads to the production of ammonia that is further converted into urea. Both ammonia and urea are nitrogenous compounds. Your liver releases urea into the blood which is then carried out to the kidneys. In the kidneys, urea is filtered from the blood and flushed out of the body via urine. This is a continuous process, so a small amount of urea nitrogen always remains in the blood.

In the case of a kidney or liver disease, there is a change in the amount of urea present in the blood. If your liver produces urea in an increased amount or if there is any problem in kidney functioning, there might be difficulty in filtering out the waste products from the blood, which can result in increased urea levels in the blood.

The BUN/Creatinine Ratio test helps compare the levels of blood urea nitrogen to that of creatinine in your body. Urea is a waste product that is formed in the liver when you eat protein, which is then metabolized into amino acids. This process leads to the production of ammonia that is further converted into urea. Later, the urea is passed out of your body through the urine. On the other hand, creatinine is a byproduct produced by muscles during energy production. Therefore, the more muscle you have, the more creatinine your body produces. The kidneys remove both the urea and creatinine via urine, and this test determines how well your kidneys are functioning.

The Blood Urea test measures the level of urea in the blood. Urea is a byproduct of protein metabolism. Proteins you consume in your diet are digested and converted into amino acids, which are then utilized by the body. This metabolic process produces a toxic byproduct known as ammonia. Ammonia is then rapidly converted into urea by your liver. Urea is comparatively less toxic than ammonia and is transported to the kidneys via the blood. The kidneys then filter it out through the urine. This process continues and the body keeps producing and eliminating urea, maintaining its low and steady levels in the blood.

The Sodium test measures the amount of sodium in your body. Sodium is present in all body fluids and is found in the highest concentration in the extracellular fluid. The body absorbs the required amount of sodium through dietary salts, and the kidneys eliminate the remaining sodium. The body keeps your blood sodium within a regular and steady range by following three mechanisms:

• By producing hormones that control the elimination of sodium through urine, such as natriuretic peptides and aldosterone.

• By producing hormones that prevent water loss, such as antidiuretic hormone (ADH).

• By controlling thirst (an increase in blood sodium level can make you thirsty and cause you to drink water, returning your sodium to normal).

These mechanisms regulate the amount of water and sodium in the body and control blood pressure by keeping the amount of water in check. When the sodium level in the blood changes, the water content in your body changes. These changes can be associated with dehydration, edema, and changes in blood pressure.

The Chloride test measures the amount of chloride in your body. Chloride is present in all body fluids and is found in the highest concentration in the blood and extracellular fluid (fluid present outside the cells). The body gets most of the chloride through dietary salt (sodium chloride or NaCl) and a small amount through other food items. The required amount of chloride is absorbed in the body and the excess amount is excreted by the kidneys through urine. When the chloride is combined with sodium it is mostly found in nature as salt. Chloride generally increases or decreases in direct relationship to sodium but may also change without any changes in sodium levels when there are problems with the body's pH. Usually, the normal blood chloride level remains steady with a slight fall after meals (because the stomach produces hydrochloric acid using chloride from the blood after we eat food).

The Potassium test measures the levels of potassium in your body. Potassium is one of the key electrolytes that helps in the functioning of the kidneys, heart, nerves, and muscles. It also balances the effect of sodium and helps keep your blood pressure normal. The body absorbs the required amount of potassium from the dietary sources and eliminates the remaining quantity through urine. Potassium level is typically maintained by the hormone aldosterone. Aldosterone acts on the nephrons present in the kidneys and activates the sodium-potassium pump that helps the body reabsorb sodium and excrete potassium. This aids in maintaining a regular and steady potassium level in the blood.